Table Of ContentThe Crisis of Care : Affirming and
title: Restoring Caring Practices in the Helping
Professions
author: Phillips, Susan S.
publisher: Georgetown University Press
isbn10 | asin: 0878405992
print isbn13: 9780878405992
ebook isbn13: 9780585276519
language: English
Caring, Helping behavior, Professional
subject
ethics.
publication date: 1996
lcc: BJ1475.C75 1996eb
ddc: 174
Caring, Helping behavior, Professional
subject:
ethics.
Page iii
The Crisis of Care
Affirming and Restoring Caring Practices in the Helping
Professions
Edited by
Susan S. Phillips and Patricia Benner
Page iv
Georgetown University Press, Washington, D.C. 20057
© 1994 by Georgetown University Press. All rights reserved.
Printed in the United States of America.
10 9 8 7 6 5 4 3 1994
.
THIS VOLUME IS PRINTED ON ACID-FREE OFFSET BOOKPAPER
This work was funded in part by the Lilly Endowment, Inc.
Library of Congress Cataloging-in-Publication Data
The Crisis of carev : affirming and restoring caring practices in the
helping professions / Susan S. Phillips, Patricia Benner, [editors].
p. cm.
1. Caring. 2. Helping behavior. 3. Professional ethics.
I. Phillips, Susan S. II. Benner, Patricia E. III. Title: Helping
professions.
BJ1475.C75 1994
174--dc20
ISBN 0-87840-558-5
94-9702
Page v
Contents
Preface vii
Introduction 1
Susan S. Phillips
Narrative: 17
When Life Threatens
Harvey Peskin
Understanding Caring in Contemporary America 21
Robert N. Bellah
Narrative: 36
Listening to the Heart
Lynn Schimmel
Caring As a Way of Knowing and Not Knowing 42
Patricia Benner
Narrative: 63
Meeting at the Table
Douglass E. Fitch
Teach Us to Care and Not to Care 66
Eugene H. Peterson
Narrative: 80
No Safe Conduct
William Visick
Page vi
The Caring Physician: Balancing the Three Es: 83
Effectiveness, Efficiency, and Empathy
E. Dawn Swaby-Ellis
Narrative: 95
To Care Is to Listen
Mima Baird
Preparing Students for the World 97
Jaime Escalante
Narrative: 105
Photograph
Sandi Schaffer
The Corrosion of Care in the Context of School 109
Anna E. Richert
Narrative: 119
Death by Choice
Theresa Stephany
Beyond the Ethics of Rightness: The Role of Compassion 123
in Moral Responsibility
David C. Thomasma
Narrative: 144
Beyond the Clinical Gaze
W. Thomas Boyce
Caring as Gift and Goal: Biblical and Theological 149
Reflections
Joel B. Green
Narrative: 168
Listening with Care
Morris A. Magnan
Philosophical Reflections on Caring Practices 174
Charles Taylor
Contributions 189
Page vii
Preface
This book argues that examining our exemplary caring relationships
can prompt us to redesign the structures and processes of our public
caregiving institutions in order to better facilitate practices of caring.
The premise is that we must first understand the best of our caring
practices by attending to the notions of the good life and skilled
ethical comportment embedded in them. Listening to narratives of
practice enables that kind of attention, and the reader will find many
narratives in this book, both free-standing and incorporated in
chapters.
There is a subtext in each chapter that concerns recovering a vision,
concrete strategies, and moral space for caring practices. Teaching,
nursing, medicine, psychotherapy, and pastoral ministry are written of
from the inside in terms of excellent practice and qualitative
distinctions (Kierkegaard, 1962; Rubin, 1984; Taylor, 1989) that
interact with it in the everyday work of helping professionals.
The authors in this book write of actual, less than ideal, circumstances
and the real people who practice care within those circumstances. If
caring practices are to be noticed, affirmed, and restored, this must
happen in the context in which they take place. The reader is invited
to examine the narratives in terms of the practices of care illustrated in
them. How is the story itself constituted by ethical concerns? What is
being protected? What are the visions and relational issues of the one
caring and the one cared for? In what ways are technological,
managerial views of the person overcome so that the other person is
encountered as a particular person with a distinct history and
concerns? We believe it is essential to recover the vision of what is
possible in actual practices today in order to discover the mandates for
reshaping our institutional structures, environments, and economics to
serve attentive, sustaining, and healing relationships.
Page viii
We have a strong tradition of considering theory liberating and
practice enslaving or unenlightened; however, this is not always the
case (Taylor, 1989). As the narratives in this book show, excellent,
instructive practice that embodies distinctions of worth creates the
vision of what ought to be and how to live toward that vision. A
dominant strategy in all the helping professions has been to objectify
and standardize as much of the professional activity as possible in the
quest for quality control. But this strategy obscures the requisite
judgment and particularized relationships required in the helping
professions.
A helping professional is not a teacher, nurse, physician,
psychotherapist, or pastor simply by virtue of possessing large
quantities of information and adhering to objectifiable codes of
behavior that limit (or exclude) judgment and response (Rubin, 1984).
These practitioners do possess the necessary information and behavior
codes; they also have experientially embedded standards and visions
of excellence. They have notions of what counts as excellent and poor
practice, qualitative distinctions about what counts as preserving
personhood, fostering growth, restoring wholeness and integrity,
offering encouragement, and so on. By examining concrete instances
of caring practice we can recover distinctions of worth within the
practice.
There are many paradoxes in caring practices. If the helping
professional acts on general principles to "act caringly" as a means of
self-improvement or salvation, or as a means of controlling fears of
finitude and vulnerability, then the caring practice will suffer. The one
cared for will be objectified, enslaved, or infantilized rather than
liberated and strengthened by care. These are real dangers that have
fueled the epidemic level discourse on pathologies of care, burnout,
and codependency. The parallel danger is to pathologize care in
general for fear of inauthentic care or from failure to hope that
Description:By combining stories of care, the reflections of caregiving practitioners, and interpretations of caregiving within a larger social and theoretical framework, this collection identifies the values and skills involved in quality caregiving at the individual level and affirms their importance for resh
